Question:  I have been asked to start a Cobb that was just recently diagnosed with EPSM. She has never had fortified grain, just a hay stretcher to deliver a prebiotic nightly. She is on pasture but we have limited that to night time only when sugar is low. I have put off saddling her and belly over and all that until I see some real strength in that hind end. I have read that oil/fat needs to replace the carbs that she is not processing into useable energy. I looked to CocoSoya, thinking it might be more palatable than just plan coconut oil but didn't like the fact that there is soybean in the makeup. I don't want to add an inflammatory to this whole situation, plus the GMO factor doesn't seem favorable. What are your thoughts? Dr. Kellon: If you do go with the high fat diet, rest assured that CocoSoya has been used successfully for many years and is the most palatable option. It has lower omega-6 than any other vegetable oil option and you can supplement with flax to boost omega-3 content. Flax is safe for EPSM horses as it has a very low sugar and starch content.  As for GMO, it's just not an issue with oils.  GMO plants can have unique proteins but their fat/oil content is not altered in any way. The high fat diet works for many, but not all, EPSM horses.  There can also be complications of obesity and metabolic syndrome with laminitis risk.  Some horses also start refusing the high fat after a while.  An alternative you could try is supplementing with acetyl-L-carnitine, 1 gram per 100 pounds of body weight:
This typically works quicker than the high fat diet and you will see improvements within 1 to 4 weeks rather than months.
It is also important to feed adequate salt, vitamin E and selenium, magnesium and protein possibly including specific amino acids of lysine, leucine and glutamine.